All Quiet on the Southern Front: There Are Few Reported Cases of COVID-19 in Texas’ Colonias, But Also Few Testing and Hospital Resources

click to enlarge JAMES DOBBINS
James Dobbins
Amid the pandemic, the Borderland is quiet. For now.

Off the unpaved Military Highway just north of the Rio Grande River, I drove into a rural village called Los Ebanos in search of the novel coronavirus in the colonias. On that recent Sunday, none of the 300-odd residents were outside to ask questions about the outbreak sweeping the planet.

Los Ebanos, however, was not silent.

A federal helicopter hovered overhead deterring river crossers. Numerous Customs and Border Patrol vehicles drove in haste over the streets, officers going about their business of detaining foreigners.

“I don’t know about the people here, but the virus reduced the smuggling,” an agent told me as we chatted a while from the safe distance of our vehicles as we parked next to a cemetery.

We talked about the weather and our hometowns back east. After suggesting I contact public affairs for comment on the virus, the agent left.

It seemed more powerful forces than a pandemic besieged Los Ebanos, one of the impoverished unincorporated settlements along the Mexican-American border.

Here, the residents often lack functional services, such as sewer systems, trash removal and electricity. Some neighborhoods don’t have access to clean drinking water. In Texas, an estimated 500,000 people, mostly Hispanic, people live in colonias. Many do not have health insurance or money to buy primary preventative care. Before the current economic downturn, the median household income in the settlements was less than $30,000 a year.

“Twenty-eight percent of our population has diabetes,” Dr. Brian Wickwire said of the individuals he treats at Nuestra Clinica de la Valle in the town of San Juan.

The clinic, with its 11 locations, serves a population of 27,000 in the Lower Rio Grande Valley. Most of the Wickwire’s patients live in colonias.

“And of that population, 2,000 have some form of kidney disease,” he said. “The rates of pre-existing conditions are similar to inner-city New Orleans or Detroit.”

COVID-19 is most fatal to patients with pre-existing conditions. And some many not even realize they have an underlying disease until it's too late.
LabCorp, a S&P 500 medical testing business, has supplied only 120 kits for Wickwire’s staff to use to detect COVID-19. The company replaces the used swabs one for one. Because Wickwire must ration the tests carefully, he worries the lab may be missing asymptomatic carriers.

LabCorp did not respond to a request for comment.

“We have been testing patients who are over 65 or less than 65 with medical conditions and symptoms,” he said. “This follows the CDC guidelines.”

Wickwire and his staff have confirmed three COVID-19 cases at the San Juan clinic. None required hospitalization. To reduce the chance of community spread, he’s encouraged patients to avoid the clinic if possible.

“Most of our patients do not have health insurance,” he said. “So, they would have to go through the ER and be treated as uninsured.”

John-Michael Torres, a representative of La Unión del Pueblo Entro (LUPE), said his community organizing group has contacted more than 5,000 individuals living in colonias to learn what they need as they ride out the crisis.

“Our members are not seeking a way to get tested,” Torres said. “This is a population that doesn’t have the same sense of agency to find out what is going on. If they find out they have a condition, they know they won’t have money to pay for healthcare. So, they don’t seek regular checkups.”

Foremost, members of LUPE are concerned about their economic lives. Worry over an invisible virus isn’t as pressing a reality when one is already financially struggling — and now losing paid work under shutdown orders.

Undocumented residents and their U.S.-born children have been left out of the mainstream economic system for so long, Torres said he’d be surprised if they expected help from the government.

“The colonias have such poor infrastructure,” he said. “There is limited, if any, access to the internet. People don’t have computers or upgraded mobile devices. The parents struggle to try to help their kids do [remote] schoolwork, and telemedicine doesn’t reach colonias.”

While COVID-19 cases surge in other parts of the state, the emergency room at Starr County Memorial Hospital in Rio Grande City has seen few diagnoses, said Dr. Jose Vazquez, the hospital’s administrator.

“We have been very fortunate,” he said. “We had only 14 COVID cases in our community. The last five were all members of the same family in the same household. Zero mortality.”

The hospital has 48 staffed beds available, no ICU beds and eight ventilators to serve a population of 60,000 people. It’s easy to imagine a spike in severe COVID-19 cases overwhelming the facility’s meager resources.

Even so, Vazquez brushed off skepticism, saying his hospital was well prepared.

“We have activation agreements with hospitals in the Valley,” he said. “And if required, they take a lot of our patients. We transfer serious cases to McAllen, which is only 45 minutes away.”

Yet burden-sharing agreements between hospitals don’t necessarily increase the capacity for the region as a whole. If the worse was to happen and Starr County became overwhelmed with novel coronavirus cases, could other Rio Grande Valley hospitals handle the overflow?

The other emergency rooms contacted for this story didn’t return calls for comment.

Stay on top of San Antonio news and views. Sign up for our Weekly Headlines Newsletter.